Association of colonic diverticulosis with colonic polyps and rectal hemorrhoids: A 4-year experience in a tertiary referral center

ABSTRACT Background: Colonic diverticulosis is a prevalent gastrointestinal condition that is often diagnosed incidentally. However, its association with colonic polyps and rectal hemorrhoids remains underexplored, particularly in the northern region of Saudi Arabia. This study aimed to assess the relationship between colonic diverticulosis and colonic conditions, when considering demographic and clinical factors. Methods: This retrospective observational study was conducted at King Abdulaziz University Hospital, Jeddah, over 4 years. Data from 4014 patients who underwent colonoscopy were analyzed. Statistical tests, including Chi-square and independent samples t-tests, were used to determine the associations between diverticulosis, polyps, hemorrhoids, and bowel preparation adequacy. Results: Diverticulosis was observed in 14.2% of the patients, with a higher prevalence among males (16.1%) than among females (12.1%; P < 0.001). Patients with diverticulosis were significantly older (mean age: 61.35 years) than those without diverticulosis (mean age: 48.25 years; P < 0.001). Hemorrhoids were more frequent in patients with diverticulosis (18.6%) than in those without diverticulosis (11.9%; P < 0.001). A similar association was found between diverticulosis and polyps, with the polyp prevalence being higher in patients with diverticulosis (21.4%) than in those without (11.7%; P < 0.001). In addition, inadequate bowel preparation was more common among patients with diverticulosis (17.1%) than among those with adequate bowel preparation (13.6%; P = 0.023). Conclusion: This study highlights a significant association between colonic diverticulosis and the presence of polyps and hemorrhoids. Older age and male sex were identified as the key risk factors. These findings emphasize the importance of targeted screening and optimized bowel preparation in at-risk patients. Further research is required to explore the underlying pathophysiological mechanisms and to develop preventive strategies.